Epidural and Subdural Hematomas: Dangerous Blood Clots on the Brain

To understand epidural and meninx hematomas — 2 serious consequences of head injuries — we want to understand the fundamental anatomy of the brain and its coverings. Imagine AN evil carpenter with an electrical drill bent drilling into somebody’s brain. What layers would the drill encounter in its passage from the skin of the top to its destination?

The drill would meet up with the skin so the bone (braincase) before penetrating a series of 3 membranes comprising the meninx. In sequence, the 3 membranes area unit the meninx (Latin for “tough mother”), the arachnoid female parent (cobwebby mother) and also the meninges (tender mother) so finally the brain itself.

Epidural and meninx hematomas area unit alike therein they’re plenty of thick blood (hematomas) caused by head trauma and deposited outside the brain however within the bone. However, they dissent in their locations relative to the meninx. AN epidural haematoma lies outside (on prime of) the meninx, whereas a meninx haematoma lies within (beneath) the {dura female parent|dura|meninx|meninges} and outdoors the arachnoid mater. Thus, the locations of the 2 types of haematoma area unit encoded in their names — “epi” is Greek for “upon” and “sub” is Latin for “below.” a 3rd reasonably haematoma caused by head injuries is traumatic neural structure hemorrhage. These occur among the brain tissue itself and are not any less serious than those outside the brain, however don’t seem to be the topic of the present essay.

Epidural and meninx hematomas area unit made by ruptures of various blood vessels. Epidural hematomas area unit typically caused by injury from AN artery that nourishes the meninx referred to as the center arterial blood vessel, whereas meninx hematomas area unit typically thanks to injury from veins that drain blood far from the surface of the brain.

Yet another distinction between epidural and meninx hematomas is what they appear like on computed tomographic (CT) scans. once the injury was recent, each show up as intensely bright objects on the scan, however the shapes of the blood clots area unit completely different. In epidural hematomas the blood is additional restricted in its unfold as a result of it’s to push more durable to maneuver outward within the tight house between the inner surface of the bone and also the outer surface of the meninx. In distinction, the injury that produces meninx hematomas is additional absolve to unfold within the looser house at a lower place the meninx and usually runs from the front of the top to the rear.

One issue that applies to each types of hematomas is that they occupy house — generally lots of it — among the brainpan wherever there is not lots of additional house to travel around. As they expand they compress the brain tissue next to them and in addition raise the pressure among the bone which may harm the remainder of the brain. Moreover, the haematoma isn’t essentially the sole drawback caused by the top injury. The blow to the top that caused the bleed also can harm the brain tissue directly.

Who gets epidural hematomas? they typically occur in folks with obvious and important blows to the top, as from car accidents. In one study they were gift in 100 percent of head-injured patients United Nations agency found AN emergency department in coma, however they will even be seen in aware patients. Epidural hematomas typically occur in conjunction with bone fractures, and this can be no coincidence, because the burst vessel typically lies at a lower place the fracture. The presence of AN epidural haematoma signifies a extremely dangerous condition. Between five and forty third of individuals United Nations agency have them die. Emergency surgery to get rid of the clot is that the usual treatment.

When considering meninx hematomas, it’s helpful to divide them into acute and chronic varieties, with “acute” which means the haematoma is new, and “chronic” which means it’s been gift for a minimum of 3 weeks. (The haematoma also can meet up with a “subacute” section, which means that it’s been gift for three days to three weeks.) By the time AN acute meninx haematoma has become chronic, it’s a thick liquid rather than a solid grume, and additionally seems darker on CT scans.